Evolution of Full Facial Feminization Surgery: Creating the Gendered Face With an All-in-one Procedure

Area of Science:

• Plastic and Reconstructive Surgery
• Transgender Health
• Facial Surgery

Background:

• Facial feminization surgery (FFS) enhances the female facial profile for transgender individuals.
• Full FFS (F-FFS) involves complex modifications of hard and soft facial tissues.
• Existing FFS procedures often require specialized expertise and can be extensive.

Purpose of the Study:

• To describe a novel, single-stage "all-in-one" approach to full facial feminization surgery (F-FFS).
• To evaluate the technical feasibility, outcomes, and patient satisfaction of this evolved F-FFS technique.

Main Methods:

• Retrospective review of 49 FFS patients (January 2003 - December 2017).
• Identification of 9 patients who underwent the "all-in-one" F-FFS procedure.
• Analysis of operative time, postoperative recovery, complications, and patient satisfaction.

Main Results:

• The "all-in-one" F-FFS was performed in a single surgery with a mean operative time of 281 minutes.
• No wound infections, dehiscence, or nerve/vessel damage were reported.
• Patients returned to work within 30 days, reporting high satisfaction and low morbidity.

Conclusions:

• The "all-in-one" F-FFS represents a significant evolution in facial feminization surgery.
• This technique offers improved surgical outcomes, higher patient satisfaction, reduced costs, and minimal morbidity.